Abstract
BackgroundDue to the high risk and severity of recurrence after stroke attack, recurrence is a major reason contributing to the disease burden. This study aims to determine whether recurrence is a significant contributor of hospitalization cost in items for ischemic stroke patients.MethodsThis study assessed acute ischemic stroke patients admitted to an academic medical center in 2003 through 2009. The t-test and Chi-square tests were used to compare first-ever and recurrent ischemic stroke groups in terms of total and categorized hospitalization cost, and multiple regression was performed to assess the influence of stroke recurrence.ResultsRecurrent ischemic strokes were associated with higher total cost, but examination cost showed no difference between the two groups. The recurrent stroke group showed higher laboratory but lower imaging cost. Of imaging studies, there was no significant difference in computed tomography scan cost while the first-ever stroke group spent more on magnetic resonance imaging and sonography. Controlling for other influential factors, recurrence was discovered to be a significant factor in lowering examination cost.ConclusionsThe findings of stroke recurrence in lowering examination cost could be explained from two perspectives, different clinical patterns of healthcare utilization and patients' economic status in recurrent stroke.
Highlights
The patients were diagnosed based on the results of anamnesis, neurological testing, computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography, and other neuroradiological findings
There was no significant difference between the two groups in terms of transient ischemic attacks (TIA), hyperlipidemia, and heart diseases (Table 1)
Previous studies showed that the longterm cost over one year was higher in patients with recurrent stroke than in those who had first-ever stroke but with no difference observed in acute medical cost between the two groups [10,11]
Summary
According to the metaanalysis with 13 studies of stroke recurrence, the cumulative risk is 3.1% within the first month, 11.1% within the first year, 26.4% in 5 years, and 39.2% in 10 years [1]. Patients with recurrent strokes generally suffer more severe strokes, higher mortality rates, and worsened functional statuses compared to patients with first-ever strokes [3,4,5,6]. The increasing number of cases of recurrence is the major reason it is becoming the main factor contributing to the disease burden of stroke [7,8]. Due to the high risk and severity of recurrence after stroke attack, recurrence is a major reason contributing to the disease burden. This study aims to determine whether recurrence is a significant contributor of hospitalization cost in items for ischemic stroke patients
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